| Page (PDF) | 9 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Collier, Samuel W. |
| Place of Death | Somerset |
| Town of Death | Westover |
| Sex | M |
| Race | Colored |
| Married, Widowed, or Single | Married |
| Date of Birth | 7/12/1883 |
| Age (year, month, days) | 29 yrs 0 mos 9 days |
| Occupation or Employer | Fireman (Traction Engine) |
| Birthplace | Maryland |
| Father's Name | George H. Collier |
| Father's Birthplace | Maryland |
| Mother's Name | Laura Waters |
| Mother's Birthplace | Maryland |
| Informant (Relationship and Address) | Sadie Collier, Wstover Md |
| Date of Death | 7/21/1912 |
| Cause of Death and Time Attended by Doctor | Toxaemia due to scald, 5 days |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | Henry M. Lankford, M.D. Princess Anne Md |
| Burial Place, Date, Undertaker, and Address | x |
| Length of Residence, Where Disease Contracted, Former Residence | – |
| Other Notes | – |
If you are citing this record, please use the following format:
[Author (if known)], Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922, [Date (if known)], Enduring Connections: Exploring Delmarva’s Black History, Nabb Research Center, Salisbury University.
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